Author Topic: Prolia med with injection- patient provides own medication  (Read 151 times)

Ruthie1972

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Hello,
WE have patients that provide their own Prolia and the charge is entered as .01 as a place holder but the ins company Martins point is still paying for this and then billing the patient for their co insurance.

Is there a modifier that needs to be added to let the insurance company know not to bill or pay for the medication when the patient provides it?

kristin

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Re: Prolia med with injection- patient provides own medication
« Reply #1 on: May 26, 2020, 10:16:20 PM »
I know of no modifier for this...the charge for the Prolia supplied by patient should be entered as a zero charge, not a penny. Is there a reason why this isn't being done?

Ruthie1972

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Re: Prolia med with injection- patient provides own medication
« Reply #2 on: May 27, 2020, 11:55:37 AM »
hi Kristin,
I was told it is just a placeholder, they do not actually get charged...do you think it would make a difference if it was a zero charge?

Michele

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Re: Prolia med with injection- patient provides own medication
« Reply #3 on: May 30, 2020, 04:27:44 PM »
I also think it should be a zero charge, or left off the bill completely. 
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Ruthie1972

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Re: Prolia med with injection- patient provides own medication
« Reply #4 on: June 10, 2020, 10:12:44 AM »
Thank you both so much.